Right ventricular thrombus

Images and  text Genevieve Carbonatto A 35 year old man presents to the Emergency Department with severe shortness of breath. He is known to have an amphetamine induced cardiomyopathy. His heart rate is 129/min, BP 116/76. He has mild pedal oedema. His JVP is elevated and on auscultation he has crepitations bilaterally. You decide to Read more about Right ventricular thrombus[…]

Assessment of Pericardial effusion

Text and images Genevieve Carbonatto Pericardial effusions are commonplace. A pericardial effusion is not synonomous with pericardial tamponade. Pericardial tamponade is a medical emergency characterised by shock and associated with a number of clinical criteria including Becks triad (hypotension, decreased heart sounds, elevated JVP) pulsus paradoxus ( > 12 mmHg drop in BP on inspiration), Read more about Assessment of Pericardial effusion[…]

Takotsubo cardiomyopathy

Images and text Genevieve Carbonatto A 52 year old lady presents to the Emergency Department with chest pain. After an argument with her husband about his spending she developed acute severe central chest pain radiating down her right arm. She is mildly SOB. There is no past history of note, notably no cardiovascular risk factors. Read more about Takotsubo cardiomyopathy[…]

ECHO : image optimisation

Images and text Genevieve Carbonatto The most difficult and frustrating ultrasound examination in the Emergency department must be the ECHO exam. What can we do to optimise our images ? Here are some tips and tricks. 1. Positioning the patient Some of our patients in the Emergency Department cannot be moved because of body habitus Read more about ECHO : image optimisation[…]

Cardiac arrest : Aortic dissection

Images Sarah Vaughan (Emergency Registrar) text Genevieve Carbonatto There is a BAT call. The ambulance are bringing a 72 year old woman who suddenly , in front of her husband, was seen to  slump to one side and appeared to have a left hemiplegia. In transit to hospital she has become less responsive and has Read more about Cardiac arrest : Aortic dissection[…]

Cardiomyopathy – Postpartum Shortness of Breath

Images and text Genevieve Carbonatto History: A young 32 year old lady presents to the Emergency Department SOB (short of breath). She is 4 weeks postpartum and was well during her pregnancy. She did not suffer from pre eclampsia during or just after her pregnancy. The baby was born by Caesarian section. She descibes being Read more about Cardiomyopathy – Postpartum Shortness of Breath[…]

Endocarditis – Shortness of breath

Images Genevieve Carbonatto. Text Genevieve Carbonatto and Tina Cullen. Featured image, NZ rain forest Abel Tasman National park A young man presents to the Emergency Department with SOB (shortness of breath). He has been sent in by his flatmates because he is so unwell. They leave as soon as he presents to triage. He is Read more about Endocarditis – Shortness of breath[…]